Organization
GREENLIFE WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRICK TANG D.C. (CLINIC DIRECTOR)
(626) 297-2340
Entity
Organization
Contact information
Practice address
18340 COLIMA RD STE 2D, ROWLAND HEIGHTS, CA 91748-2785
(626) 297-2340
Mailing address
18340 COLIMA RD STE 2D, ROWLAND HEIGHTS, CA 91748-2785
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
27175
CA
111NS0005X
Sports Physician Chiropractor
27175
CA
111NX0800X
Orthopedic Chiropractor
Primary
27175
CA
Other
Enumeration date
05/11/2009
Last updated
05/11/2009
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